Department of Agricultural Development, Laboratory of Management and Marketing, Democritus University of Thrace, Orestiada, Greece.
GESIS-Leibniz Institute for the Social Sciences, Mannheim, Germany.
Nutr J. 2018 Nov 5;17(1):101. doi: 10.1186/s12937-018-0408-0.
This study explored the influence of cigarette smoking and food consumption patterns on BMI after adjusting for various socio-demographic characteristics. Since weight-based stereotypes may have an impact on smoking behaviour and both obesity and smoking have been associated with detrimental health effects, an interdependency between them is quite possible.
Cross-sectional data were collected via a formal standardized questionnaire administered in personal interviews and two additional self-completion questionnaires from a random sample of 3471 German adults. The empirical framework considered potential endogeneity between smoking and body weight by employing an endogenous treatment effects model with an ordered outcome. The estimations derived from the endogenous treatment effects approach were also compared to the univariate ordered probit model results.
Our findings showed that ignoring potential endogeneity may affect both the statistical significance of the smoking estimate and the direction of the influence of smoking on BMI. Smoking was positively associated with BMI in both male (β = 1.236, p < 0.01) and female (β = 0.634, p < 0.10) participants. Smokers presented a 23.1% higher risk of obesity and a 24.3% lower likelihood of being within a healthy weight range. Male smokers also appeared to have a considerably augmented probability of being obese compared to their female counterparts (23.6% vs 15.1%). The relationship between smoking and BMI may be attributed to dietary practices, since smoking was correlated with poor dietary habits characterized by the frequent intake of more energy-dense foods (meat products and white-toasted bread) and less frequent consumption of healthy food items, such as whole-grain bread, vegetables and fruits. Concerning the impact of eating habits on body weight, frequent consumption of meat products and confectionery was found to have a direct association with BMI in both genders. Furthermore, white-toasted bread consumption was negatively linked with body weight in males (β = - 0.337, p < 0.01).
Our findings raised questions about the general belief that smoking is an effective weight control tool. Health interventions should be oriented toward a simultaneous decrease in smoking and obesity, since both behaviours seem to be interdependent. Nutrition programmes should also be designed according to the characteristics of different target groups in order to promote a healthy lifestyle.
本研究通过调整各种社会人口特征，探讨了吸烟和食物消费模式对 BMI 的影响。由于体重相关的刻板印象可能会对吸烟行为产生影响，而肥胖和吸烟都与健康不良后果有关，因此它们之间存在相互依存关系。
通过对 3471 名德国成年人进行个人访谈和两份额外的自我完成问卷的正式标准化问卷收集横断面数据。实证框架通过使用有序结果的内生处理效应模型考虑了吸烟和体重之间潜在的内生性。从内生处理效应方法得出的估计值也与单变量有序概率模型结果进行了比较。
我们的研究结果表明，忽略潜在的内生性可能会影响吸烟估计的统计显著性和吸烟对 BMI 的影响方向。吸烟与男性（β=1.236，p<0.01）和女性（β=0.634，p<0.10）参与者的 BMI 呈正相关。吸烟者肥胖的风险增加 23.1%，处于健康体重范围内的可能性降低 24.3%。与女性相比，男性吸烟者肥胖的可能性明显增加（23.6%比 15.1%）。吸烟与 BMI 之间的关系可能归因于饮食行为，因为吸烟与不良饮食习惯有关，表现为频繁摄入更多能量密集型食物（肉类产品和白烤面包）和较少食用健康食物，如全麦面包、蔬菜和水果。关于饮食习惯对体重的影响，研究发现男性中频繁食用肉类产品和糖果与 BMI 呈直接相关。此外，白烤面包的摄入与男性体重呈负相关（β=-0.337，p<0.01）。
我们的研究结果引发了对吸烟是一种有效的体重控制工具的普遍看法的质疑。健康干预措施应针对同时减少吸烟和肥胖，因为这两种行为似乎相互依存。营养计划也应根据不同目标群体的特点设计，以促进健康的生活方式。
